Latent bipolarity/possible bipolar 2?

I don’t know if this is a question anyone can answer but I’m curious to see if anyone can relate to it. I’ve suffered from depression for as long as I can remember and I first experienced suicidal ideation when I was 10 years old.
I’ve been on a number of SSRIs and SNRIs over the years, most of which haven’t worked. I’ve been diagnosed with unipolar depression and GAD, but my psychiatrist is concerned because bipolar disorder is rampant in my family. I have relatives on both sides of my family who have bipolar 2, but my maternal grandmother suffered the most with Bipolar 1 with psychotic features. However, her case is a bit unusual because most people begin to experience symptoms of bipolar in their teens and twenties. She may have experienced some milder symptoms as well, but from what I’ve been told by my grandfather and my mom, she never had a severe episode of depression or mania until she was in her 50s, and it seemed like it was triggered by the death of her mother, whom she was very close to. Her first suicide attempt occurred after that, followed by two more attempts that alternated with severe manic episodes.
My psychiatrist said that it’s possible I have bipolar 2, however, I’m in my 30s and have never experienced a manic episode, at least I don’t think. I recently learned that I could be diagnosed with bipolar 2 even if I’ve only ever experienced one hypomanic episode that lasted for a few days. Now I’m mentally scouring through my past to think of any times when I may have been “too happy” for a couple days to a week, but it’s hard to tell because I’ve had depression for so long that I don’t know if I can distinguish the difference between “normal happy” and “hypomanic happy.”
Anyway, I just wanted to throw this out there for discussion. I know it’s a family mystery for me that no one can solve, as my grandmother passed away a few years ago. Maybe this is a situation of “if I have to ask if I have bipolar disorder, I probably don’t.” My only concern is that I have some type of latent bipolarity, that could explain why ADs haven’t helped me and I should be looking into meds that treat bipolar disorder. I should also be concerned about ADs throwing me into a hypomanic state, although that never has seemed to happen.

Hi @Rosepetal99 . Welcome to Psych Central. I am sorry for the losses you have experienced and the uncertainty of what your diagnosis might be. The mental health professional is the only one that can diagnose you accurately. Members here can offer empathy and concern, but cannot confirm or refute a diagnosis.

In your search through your past for clues, you may find these articles of interest.
Manic Episode Symptoms

Symptoms that Might Predict First Episode of Mania

https://blogs.psychcentral.com/older...d-for-routine/

Feel free to reply to this post and tag me @CANDC so I know you replied.

Welcome, Rosepetal. Yeah, I was diagnosed with major depression in '97 but did not become manic and psychotic until 2005. Interviewing old pals and reviewing school records, it is clear I had childhood-onset bipolar 1
.

Bipolar disorder is notoriously difficult to diagnose. Many patients with depression likely do end up wit either bp 1 or even 2. I would suggest you read about lithium. It is being used more and more with good results in unipolar depression. Underappreciated.

My bipolarity isn't exactly certain apparently as well (I've had manias but I can't remember if I was sober so they might not count).
As for determining the difference between happiness and hypomania, hypomania usually involves regrets that you wouldn't normally do or sometimes creative or productive achievements that you would never normally accomplish, maybe even seem far fetched for the average Joe. Also look for lack of sleep but feeling energized, as this is a common one. I know I'm at least a little bit hypomanic if I sleep 2 hours and wake up feeling like I just drank an insane amount of coffee, but it can be more subtle than that, like a few hours less than you normally sleep at baseline. The key is to compare to baseline if you can, not depression.

In the mean time, discuss with your pdoc trying a mood stabilizer, especially the ones that treat the depression end as well like lamictal or, as bpcyclist said, lithium.

I wasn't diagnosed until I was 33. I know I had it at least 10 years before- but that's retrospective.

Don’t blame yourself or look for alternative diagnosis when it could be the fault of the antidepressants. There’s a ton of literature and studies proving that antidepressants very rarely work. They do cause affects so some people think that those are doing something and they do cause withdrawals so some people think that must mean they were doing something. The true is that antidepressants as a class don’t work in the majority of people. Talk to your doctor about mood stabilizers. Also lifestyle changes and CBT and DBT Can be helpful

Hi Rosepetal, You have some very valid questions that only a pdoc can give solid answers to. That said, I will share some information and experience with you.

Hypomania and mania are most definitely not always "too happy". (That would be fun, wouldn't it!) Mania often presents as dysphoric mania. So instead of happy and on top of the world, you're irritable, angry, self-righteous, and raging. And anxious, horribly, severely anxious. For some strange reason, the dysphoric side of mania is seldom discussed. It should be.

There's also mixed state bipolar episodes, which is when someone feels an extreme of emotions all at one time. Mixed states are common for me and during them (if I'm not properly medicated) I feel ecstatic, excited, think I can do anything I set my mind to, believe I know better than other people what's "best", colors are bright - no not just "bright" - they are brilliant! Colors have great meaning, music is God's very voice - I am every note I hear...and I also feel angry, short-tempered, have rages in which I have broken objects or thrown things at people...and I also feel depressed, exhausted, hopeless, extremely anxious, etc., etc. And it's all extremely intense. So intense that I feel physically unwell after a while, in chronic pain, for example.

I've never taken a single online "Do You Have Bipolar Disorder?" test that I thought really covered the disorder thoroughly and correctly.

As for antidepressants, in my experience they are very helpful, even life saving, for some people. A zillion years ago when I was prescribed an SSRI it changed my life for the good. I could feel happy and not so anxious, I wasn't afraid of shadows (literally). I felt the proverbial dark veil lift. But the AD didn't treat all the other symptoms. So eventually, it was obvious that I needed additional meds.

Late-onset mental illness, I don't know what the official word on that is. I can tell you that I have known people who seemed to develop late-onset psychosis and other symptoms of mental illness, but inside I thought to myself that it seemed more like their symptoms just became more florid, not that they were never there before.

How long have you been seeing your pdoc and do you trust him/her?